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Bunions Cause And Effect

Overview
Bunion Pain
In constrictive shoes, the big toe is forced to bend toward the second toe and the first joint of the big toe is moved out of place. To compensate for the realignment, the outside of the joint is increased in size. Tendons then begin to pull the toe into an abnormal position. Over time the change in position becomes painful and permanent. The change in position also causes the mechanics of the toes and foot to be affected. The joint at the base of the big toe carries a lot of weight when walking or running. In a normally shaped foot the position of the big toe helps create a wide base of support and stability. A foot that has had the big toe bent toward the second toe will tend to roll inward. This abnormal pronation, along with the ill-fitting shoes will make the Bunion even worse. If a person has a foot anatomy that is prone to Bunions, wearing footwear with a too-narrow toe box will accelerate the development of a Bunion. Wearing footwear with a wide toe box may help prevent or at least delay the development of Bunions.


Causes
The underlying cause is a deformity of the joint at the base of the big toe. The deformity is called hallux valgus. In this deformity the joint develops a prominent sideways angle. Due to this deformity the bones of the big toe are pushed towards the smaller toes. The skin over the angled joint then tends to rub on the inside of shoes. This may cause thickening and inflammation of the overlying skin and tissues next to the affected joint. In most cases it is not clear why a hallux valgus deformity develops. There may be some hereditary (genetic) tendency to have a weakness of this joint. In some cases it is associated with a joint problem such as osteoarthritis or rheumatoid arthritis. However, whatever the underlying cause, wearing tight or badly fitting shoes tends to make the problem worse. Wearing such shoes puts extra pressure on the big toe joint and causes friction on the overlying skin.


Symptoms
The most common complaint with bunions is pain that develops over the large bump due to shoe pressure. A red, inflamed area can develop, called a bursa. With ongoing pressure, the inflammation can cause throbbing, as it presses against the blood vessels, or swelling in the joint. Shooting pains occur when the swelling presses against the nerve. If left untreated, the constant irritation can lead to arthritis that breaks down the joint, resulting in pain and stiffness.


Diagnosis
Before examining your foot, the doctor will ask you about the types of shoes you wear and how often you wear them. He or she also will ask if anyone else in your family has had bunions or if you have had any previous injury to the foot. In most cases, your doctor can diagnose a bunion just by examining your foot. During this exam, you will be asked to move your big toe up and down to see if you can move it as much as you should be able to. The doctor also will look for signs of redness and swelling and ask if the area is painful. Your doctor may want to order X-rays of the foot to check for other causes of pain, to determine whether there is significant arthritis and to see if the bones are aligned properly.


Non Surgical Treatment
Most bunions can be treated without surgery. The first step for treating bunions is to ensure that your shoes fit correctly. Often good footwear is all that is needed to alleviate the problem. Shoes that are wide enough to avoid pressure on the bunion are the obvious first step. Look for shoes with wide insteps and broad toes and definitely no high heels. Sometimes, you can get your existing shoes stretched out by a shoe repairer. Seek advice from a podiatrist. Pads and toe inserts. Protective bunion pads may help to cushion the joint and reduce pain. Toe inserts are available that splint the toes straight. It may be recommended that you wear some orthotics to improve your foot position when walking. Medicines. Some people find anti-inflammatory medicines, such as ibuprofen or aspirin, or paracetamol help ease the pain of their bunions.
Bunion Pain


Surgical Treatment
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.

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